[Hormonal therapy of benign prostatic hyperplasia]

In the last 30 years transurethral prostatectomy (TURP) has been the standard treatment for benign prostatic hyperplasia. While the mortality rate of TURP has been reduced to zero, the postoperative morbidity rate has remained unchanged at 15-18% for several decades. Increasing costs and the preference of many patients for non-surgical treatment have now led to the development of new pharmacological treatment options. All hormone therapeutic modalities known to date, such as GnRH-agonists, cyproteronacetate and flutamide, have acted on the male hypothalamic-pituitary-gonadal system. Because of their side effects they are rarely used for the treatment of symptomatic benign prostatic hyperplasia. The 5-alpha-reductase inhibitor finasteride is a new endocrinological treatment option. It can be used to reduce the volume of enlarged prostates and to improve flow rates without severe side effects. According to the available data, finasteride is a safe treatment option for symptomatic patients with benign prostatic hyperplasia if surgery is not yet indicated. It should not, however, be regarded as an alternative to surgical treatment of benign prostatic hyperplasia.